EMDR: The Basics, How It Is Different From Talk Therapy, and How It Can Help You

EMDR (Eye Movement Desensitization and Reprocessing) is an incredible option to explore if you are feeling stuck in your progress with talk therapy or if you have a specific memory that is triggering, activating, or just feels like it has a “charge” (aka you cringe in your face/ body when you think of it).If any of the above resonates with you, I want to give a brief run down on the basics of EMDR, tell you how EMDR is different than talk therapy, and how EMDR can potentially benefit you.

Context

To provide a little context, EMDR is grounded within the Adaptive Information Processing model which essentially suggests that under the right set of circumstances:

1) Our brains are able to integrate new information in helpful ways

2) Our brains can heal and recover from stressful or disturbing events

For example, if a person gets into a fender bender at a tricky intersection, the adaptive processing of the brain will eventually communicate to the person: “Hey person! You’re safe now and you have such a great track record with driving, but this intersection is tricky. You might want to exercise extra caution next time you drive here”.

And while most of the time the brain is organizing, integrating, and learning from life experiences in this adaptive way, sometimes this process gets interrupted. There are a lot of reasons why processing in the brain becomes interrupted, but when it does, the event becomes a memory that is “frozen” in time and stored as fragmented, non-cohesive images, cognitions, emotions, and physical sensations.

Let’s take the above example again of the fender bender at the tricky intersection. If that memory was not adaptively processed (so the driver did not internalize “I’m safe”, “I’m a capable driver who got into an accident”), the driver might instead become hypervigilant while driving, developing chronic tension in their neck and shoulders, feel out of control when they ride in the passenger seat, etc. Although not a life-threatening trauma, with the way this memory was stored in the brain, it still holds a significant “charge”.

This is where EMDR comes in. EMDR’s overarching goal is to significantly decrease and diffuse the activation in the brain and body when remembering a difficult or disturbing memory (in other words the goal to be able to experience reminders of a past experience without your brain telling you that you are re-experiencing it currently). EMDR makes this possible by helping the brain restart and complete it’s natural adaptive processing.

The Basics of EMDR

Now that you know more about the goal of EMDR, let’s get into what treatment actually looks like. EMDR follows a very specific 8 phase protocol. The 8 phases are as follows:

Phases 1: History & Treatment Planning serves the purposes of 1) Building a relationship between the therapist and client, 2) Becoming more clear on the client’s presenting concern and contributing factors to the concern, and 3) Selecting a “target memory” to reprocess

Phase 2: Preparation ensures the client is prepared with the resources and coping skills needed to tolerate the expected stress and activation inherent to EMDR.

Phase 3: Assessment involves 1) Reiterating the presenting concern and selected memory, 2) Identifying the self-belief that was internalized by the memory (ex. I’m helpless), 3) Identifying what the client would prefer to belief about themself (ex. I’m capable), and 4) Connecting with and opening up the memory

Phase 4: Desensitization is all about safe exposure to the activating memory and kickstarting the brain’s adaptive processing system. This is accomplished by: 1) connecting with the target memory, while 2) engaging in some form of bilateral stimulation (either tapping opposite hand to opposite shoulder, back and forth eye movements, or listening to bilateral beats through headphones), while 3) remaining grounded in the safety in the present moment.

For my extra curious readers wanting to know the function of the bilateral stimulation: quickly switching between left and right brain hemispheres is what the brain does during the hours of sleep dedicated to processing, organizing, and integrating memories. Engaging in this brain activity while conscious through bilateral stimulation (ex. back and forth eye movements, tapping opposite hand to opposite shoulder, or listening to the bilateral beats) is what kick starts the brain into continuing the adaptive processing that had been interrupted.

Phase 5: Installation is about internalizing a different narrative about your self. For example if the memory lead you to internalize “I am helpless” you might internalize “I have choices now”, if you internalized “I’m unlovable” you might internalize “I am lovable” etc. This internalization is done in a structured away that involves holding the target memory and the positive belief in your mind while engaging in bilateral stimulation again (the eye movements, tapping, or auditory stimulus mentioned above).

Phase 6: Body Scan is essentially checking in with the body to see if there is any unresolved tension or reaction detected in the body after Phases 4 and 5.

Phase 7: Closure After each session the therapist will help the client end and distance from reprocessing so that the client leaves session more grounded and emotionally regulated.

Phase 8: Reevaluation actually happens at the beginning of each session once Phase 4 has been reached. The purpose to is to 1) Check-in about any new thoughts/ feelings/ insights about the presenting concern since the previous session and 2) Assess how activating the target memory is.

How EMDR Is Different from Talk Therapy

Talk therapy largely relies on insight building and change occurring through talking and conversation between the client and therapist.

In contrast, in most of the EMDR phases, clients do not have to verbalize the specifics about the distressing memory to the therapist. During Phases 4, 5, and 6 of EMDR, the client is paying attention to the thoughts, emotions, and physical experiences in their body while engaging in bilateral stimulation, and only briefly reporting back to the therapist what they are noticing. The client and therapist follow the flow of the client’s brain with minimal re-direction (this allows the processing of a ‘stuck’ memory to resume).

How Can EMDR Benefit You?

Although EMDR was originally designed to support people experiencing Post Traumatic Stress Disorder (and remains an evidence based and recommended practice for veterans returning from service), it has shown to be equally effective in supporting anxiety, OCD symptoms, phobias, and general well-being for people impacted by pervasive negative self-beliefs.

EMDR can help you:

• Establish an internal sense of safety

• Create a more regulated nervous system

• Contextualize distressing memories as occurring in the past (versus the brain being activated as if it is happening now)

• Internalize positive, helpful self-beliefs: “I am lovable”, “I am capable”, “I am safe”, “I did nothing wrong”, “I can identify people I can trust”

• Experience relief faster than solely talk therapy

EMDR is clearly just one of many helpful therapy modalities, but if you are interested in seeing if it is a good fit for you, feel free to email or text me to set up a free 15 minute consultation.

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